Recurrent dermatomyositis manifesting as a sign of recurrent transitional cell carcinoma of urinary bladder: Long-term survival

Abstract

The association between urological malignancies and paraneoplastic syndromes has been well documented. We report a case of recurrent dermatomyositis manifesting as a sign of metastatic recurrence of non-muscle-invasive transitional cell carcinoma of the bladder, a relationship which has only been referred to in a few reports. The case highlights a few important clinical challenges; firstly, the importance of thorough investigation for underlying malignancy in patients with dermatomyositis, as successful treatment of such malignancy can lead to resolution of paraneoplastic symptoms, and secondly, a high index of suspicion of recurrence in cases where paraneoplastic manifestations recur. Metastatic pulmonary recurrence without local evidence of disease at a follow-up of 4 years makes this case unique. Moreover, in the light of our experience and reported literature, a framework is suggested to approach such a diagnostic dilemma in the future. Description of the case will guide clinicians in the future, in case they encounter such an unusual clinical scenario. This could also serve as a hypothesis-generating source for designing future research as well.

Exacerbation of Dermatomyositis with Recurrence of Rectal Cancer: A Case Report

“…We also found the liver and lung metastases from rectal cancer by using blood examination of CEA followed by CT when a DM flare-up appeared approximately 4 months after surgery. This is consistent with published reports that recurrent DM symptoms following curative cancer therapy require reinvestigation, even in the absence of symptoms of malignancies [ 2 , 6 ]. However, when the patient has an unresectable malignancy, cancer chemotherapy administration difficulties exist because of poor performance status from paraneoplastic DM and occasional steroid refractoriness of DM symptoms [ 7 ].…”

Successful resection of liver metastasis detected by exacerbation of skin symptom in a patient with dermatomyositis accompanied by rectal cancer: a case report and literature review

“…Few studies reported recurring cases of DM and other cancers. These reports demonstrated the association between DM symptoms and cancer recurrence in patients with ovarian cancer [15], breast cancer [16], and bladder cancer [17], supporting our findings in colorectal cancer. The present report describes a rare case with a good outcome of resecting liver metastases that were detected early by exacerbation of skin symptoms before annual examination in a patient with DM accompanied by rectal cancer.…”

Polymyositis and dermatomyositis as a risk of developing cancer

“…However, ovarian cancer appears to be most closely connected with dermatomyositis, and the relationship of other cancers of the reproductive organ with PM and DM is relatively weak. Bladder cancer (transitional cell carcinoma – TCC) may be associated with various paraneoplastic syndromes manifesting as endocrine, neuromuscular, or hematological disorders, and paraneoplastic DM secondary to cancer of the bladder TCC is rarely observed [ 9 ]. The symptoms of DM appear extremely rarely when signs of metastatic TCC are observed.…”